Smith started by painting a rosy picture of health care in
Wisconsin. The state has the second-lowest number of uninsured people in
the country, Smith said. He also highlighted Governor Scott Walker's
infusion of $1.2 billion in new revenues to Medicaid programs. Although
the federal government gave the states the option to cut Medicaid
services and reduce eligibility, the Walker administration chose not to
exercise that option, Smith said. "Those who rely on Medicaid are far
better off because we did not adopt those federal options," he said.

Smith stressed that Medicaid users were not a monolithic
entity, but rather a diverse group with varying needs. Any reform of
Medicaid requires the state to pay careful attention to those groups
rather than trying to impose a one-size-fits-all solution.

Previous Medicaid expansions were financed by extra sources
of income, he said. "It is not realistic to think there is another new
pot of money around the corner," Smith warned. He also chided the
previous administration for failing to fund those expansions with state
money when the state reached the limits of federal funding.

Smith's speech concluded
with stern warnings about the danger of excessive federal meddling in
the health care arena. "Above all, health care is personal and local.
Centralizing decision-making for over 20 percent of our entire economy
will not turn out well for everyone."

"It is an unpleasant task to inform you that you will not find the wisdom of Solomon in the Federal Register," he said.

According
to Smith, the president's health care reforms will lead to a federal
government that is more invasive and coercive. He also accused the Obama
administration of reneging on its promise to fully fund the expansion
of Medicaid. "The President's budget includes a proposal for a blended
match rate to the states," he said. "A blended rate that saves the
federal government money is a thinly-veiled cost shift to the states."